Organization
GARDNER VOLUNTEER FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WILKEY (FIRE CHIEF)
(815) 237-8806
Entity
Organization
Contact information
Practice address
206 DEPOT STREET, GARDNER, IL 60424
(815) 237-8806
(815) 237-0066
Mailing address
35 E WILLOW ST STE B, COAL CITY, IL 60416-1869
(815) 634-3048
(815) 634-3188
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
77819
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332002
BLUE CROSS BLUE SHIELD
IL
01
—
P00154114
RAILROAD MEDICARE
IL
01
—
P00154114
RAILROAD MEDICARE
—
Enumeration date
11/17/2006
Last updated
04/20/2011
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